| NPI | 1104622158 |
|---|---|
| Former Name | BRYNNA WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 14205405-4405) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 14205405-4405) |
| Enumeration Date | 2025-02-20 |
| Last Update Date | 2025-03-07 |